Provider Demographics
NPI:1053393249
Name:WEISSTEIN, SANDRA RUBY (ARNP)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:RUBY
Last Name:WEISSTEIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 ACADEMY OAKS PL
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2806
Mailing Address - Country:US
Mailing Address - Phone:407-646-2512
Mailing Address - Fax:
Practice Address - Street 1:1000 HOLT AVE
Practice Address - Street 2:2727
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4499
Practice Address - Country:US
Practice Address - Phone:407-646-2512
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1063012363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner